01610 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla

Name of the Procedure:

Anesthesia for All Procedures on Nerves, Muscles, Tendons, Fascia, and Bursae of Shoulder and Axilla

• Common Name: Shoulder and Axilla Anesthesia
• Medical Term: Peripheral Nerve Block for Shoulder and Axilla

Summary

Shoulder and axilla anesthesia involves numbing the nerve pathways that supply the shoulder region, aiding in performing surgeries or other medical interventions without causing pain to the patient.

Purpose

This anesthesia technique addresses pain management for surgical procedures involving the shoulder and axilla. The main goal is to ensure the patient does not experience pain during the procedure.

Indications

• Shoulder surgery (e.g., rotator cuff repair, dislocation repair)
• Tendon repair or release
• Bursitis treatment
• Muscle or fascia repairs
• Nerve decompression procedures
• Patient criteria: Suitable candidates typically have no severe allergies to anesthesia and no adverse reactions to previous nerve blocks.

Preparation

• Patients may be asked to fast for a certain period before the procedure.
• Adjustments to regular medications, particularly blood thinners, may be necessary.
• Preoperative assessments may include blood tests, imaging studies, or a physical examination.

Procedure Description

1. The patient is positioned to allow access to the shoulder and axillary region.
2. An antiseptic solution is applied to clean the area.
3. Using ultrasound guidance or nerve stimulator, the anesthesiologist locates the target nerves.
4. A local anesthetic is injected around these nerves to block sensation.
5. The procedure may involve the use of catheters for continuous anesthesia delivery, depending on the surgery’s duration.

Tools:

• Ultrasound machine
• Nerve stimulator
• Needles and catheters
• Local anesthetics (e.g., lidocaine, bupivacaine)

Duration

The procedure usually takes about 30-60 minutes to perform.

Setting

This procedure is typically performed in:

• Hospitals
• Outpatient clinics
• Surgical centers

Personnel

• Anesthesiologist or pain management specialist
• Supporting nurses or anesthesia assistants

Risks and Complications

Common risks:

• Bruising or soreness at the injection site
• Temporary weakness in the shoulder or arm

Rare risks:

• Infection
• Nerve damage
• Allergic reactions to anesthetic agents

Benefits

• Effective pain management during and after surgery
• Reduced need for systemic pain medications
• Faster initial recovery due to less pain

Recovery

• Monitor for any immediate complications post-procedure
• The numbness may last for several hours post-surgery.
• Follow-up with physical therapy if recommended
• Avoid heavy lifting or strenuous activity until full recovery, typically a few days to weeks depending on surgery.

Alternatives

• General anesthesia: Pros include total unconsciousness; cons may involve more significant systemic side effects and longer recovery.
• Local infiltration anesthesia: Generally suitable for less extensive procedures with limited scope compared to nerve blocks.

Patient Experience

• During the procedure, patients might feel pressure but should not feel pain.
• Post-procedure, there may be some initial soreness or a tingling sensation.
• Pain management during recovery will often include oral pain medications and comfort measures such as ice packs or supportive slings.